Editorial: Singing and the Pandemic

Singing and the Pandemic: Return to Performance?

Note: This editorial article is intended for use in multiple publications in order to disseminate important information as widely as possible. The copyright is held by The Voice Foundation.  This document is being made available for unrestricted use at no cost. It should be acknowledged as “republished with permission from The Voice Foundation”.

There are hundreds of thousands of people whose living depends upon voice performance. These include not only singers, singing teachers, choir conductors (professional, amateur, university, secondary school, religious organizations, community, and more), actors (stage, film, television, radio) and others, but also all of the backstage staff, administrators, marketing personnel, advertising companies, printers, and many other professionals. Restrictions related to singing and other voice performance due to the COVID-19 pandemic has had enormous professional, financial, and emotional consequences. Unfortunately, but not surprisingly, concern over the current restrictions and an uncertain future has led to a plethora of unsupported opinions and publications. Fortunately, there also have been some fairly good research and consensus initiatives, one of which is discussed below.

Because there is so much emotion involved when people are told that they cannot perform or remain employed, informed leaders are seeking urgently the best possible data, advice, and guidance. Many people in all related disciplines throughout the world will look to interdisciplinary individual and organizational leaders to learn what we advise, and to observe how we behave. It is exceedingly important for leaders in all fields not only to make COVID-related employment and performance decisions wisely, but also to communicate the rationale for those decisions. While most people and organizations probably have tried to gather as much evidence and other information as possible before establishing policies, the urgency and emotional impact of decisions about singing and other performance and face-to-face contact is stressful. Everyone is under so much pressure to act that it is easy for us to act prematurely and especially to forget to explain our reasoning. If people see restrictions as having been arbitrary, or at least as not grounded in credible justification, then they might be more likely to ignore them and make the pandemic worse. Almost every day, we hear about groups that have ignored recommended precautions and gathered for parties or other events that have led to high numbers of COVID-19 infections among participants. The problem has been as severe among people who gathered socially as it was among the few choir rehearsals that led to infections and gave rise to the concept of singers as “super spreaders” (despite the absence of evidence that the outcome would have been any different if the same people had been in the same room with the same ventilation talking instead of singing). It is incumbent upon those of us in positions of leadership or influence to promulgate knowledgeable and individualized policies and to be transparent and informative about how they were reached, so that people are inclined to follow advice because they understand why they should do so.

In an effort to provide clarity and guidance, a group of 18 authors (laryngologists, speech-language pathologists, singers, singing teachers, choir conductors, a basic scientist, and others) collaborated to write “Safer Singing During the SARS-CoV-2 Pandemic: What We Know and What We Don’t”.¹ The entire voice community is indebted to Stefanie Jewell-Thomas and Elsevier, publisher of the Journal of Voice, not only for publishing this article quickly, but also for making it available at no charge for any interested reader. The DOI is https://doi.org/10.1016/j.jvoice.2020.06.028. This article summarizes science and myth and suggests areas for research that need to be pursued soon. It also provides suggestions on ways to return to singing safely, and it separates evidence from opinion clearly, trying to offer the best of both. Eleven specific suggestions are provided to guide return to singing with as much safety as possible. It is likely to be possible to follow them and resume singing in some settings, but may be impractical or impossible in others. For example, the senior author (RTS) has just canceled his 51^st anniversary fall season as Conductor of the Thomas Jefferson University Choir. The five specific safety criteria that we were unable to meet, and the reasons why remote rehearsals and performances with orchestra were not practical at our institution, were communicated to all parties, not just the singers. That has led to a level of acceptance and understanding that we believe also will keep people from congregating inappropriately to sing on their own. If we are able to proceed with rehearsals and performance in the spring, it should give them confidence that the decision will have been made with their safety in mind. The “Safer Singing” article¹ was key not only to making the decision, but more importantly to educating both performers and university administrators about the science and process behind the decision. This certainly will make it easier to gain the university’s approval to return to performance in the spring, if our analysis suggests that it is safe to do so.

We encourage our colleagues in medicine and music to consult the “Safer Singing” article¹ for guidance in each individual singing situation. It should prove useful as an aid to understanding what is known and what is unknown at this time, and as help in recognizing the many opinions that have been expressed by credible people but which have no basis on evidence or fact (so that they do not exert undue influence on performance decisions). We, along with the other authors of the article, hope especially that it will serve as an inspiration to pursue research into questions that need answers as quickly as possible.

References

1. Naunheim MR, Bock J, Doucette PA, et al. Safer Singing During the SARS-CoV-2 Pandemic: What We Know and What We Don’t. J Voice. 2020; in press.

Authors:

Robert T. Sataloff, MD, DMA, FACS
Professor and Chairman, Department of Otolaryngology – Head and Neck Surgery
Senior Associate Dean for Clinical Academic Specialties
Drexel University College of Medicine
Conductor, Thomas Jefferson University Choir
Adjunct Professor, Department of Otolaryngology – Head and Neck Surgery
Sidney Kimmel Medical College
Thomas Jefferson University
Director of Otolaryngology and Communication Sciences Research
Lankenau Institute for Medical Research

Matthew R. Naunheim, MD, MBA
Assistant Professor in Otolaryngology–Head and Neck Surgery
Harvard Medical School

Thomas L. Carroll, MD
Director, BWH Voice Program
Brigham and Women’s Hospital
Assistant Professor, Department of Otolaryngology-Head and Neck Surgery
Harvard Medical School